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Anesthesiology

Antepartum and Postpartum Hemorrhage – Prediction and Management

What the Anesthesiologist Should Know before the Operative Procedure Obstetric hemorrhage accounts for 25% to 30% of all maternal deaths worldwide and causes death in underdeveloped countries at a rate 100 times that in developed countries. Most deaths are due to postpartum hemorrhage. In developed countries, postpartum hemorrhage is the leading cause of major maternal…
Obstetrics and Gynecology

Vulvar Cancer

Vulvar Cancer 1. What every clinician should know Are you sure your patient has disease? What should you expect to find? Vulvar cancer is a relatively rare cancer that affects approximately 3,500 women annually in the United States. It is usually a relatively indolent cancer that presents with pruritis and a visible lesion. The majority…
Critical Care Medicine

Shock; circulatory failure

1. Description of the problem What every clinician needs to know Shock is a clinical syndrome where a primary circulatory problem causes impaired oxygen delivery to organs and peripheral tissues. Without rapid identification, restoration of oxygen delivery and treatment aimed at the underlying cause, a process of progressive multi-organ dysfunction and sequential organ failure will…
Cardiology

Management of Pulmonary Hypertension

I. Pulmonary Arterial Hypertension: What Every Physician Needs To Know. Pulmonary arterial hypertension (PAH) is a disorder specific to the pulmonary arteries, resulting in an increase in pulmonary artery pressure (PAP), and pulmonary vascular resistance (PVR), leading to right ventricular (RV) dysfunction, right heart failure, and death. Pulmonary hypertension (PH) refers to elevated pressure in…
Pediatrics

Overdose – Drugs of Abuse

OVERVIEW: What every practitioner needs to know Are you sure your patient has overdosed? What are the typical findings for this condition? Stimulants Stimulants are a class of compounds that accelerate neuronal and/or physical activity. These include a number of both prescription and recreational drugs such as cocaine, amphetamines, anticholinergics, and sympathomimetics. In general, they…
Nephrology Hypertension

Chronic Interstitial Nephritis

Does this patient have chronic interstitial nephritis (CIN)? Chronic interstitial nephritis (Figure 1) comprises a large and diverse group of conditions characterized by: Figure 1. Chronic interstitial nephritis. Urinary concentration defects (secondary to dysfunction of the kidney concentrating mechanism located in the medullaContinue Reading Occurs early in the course Associated: nocturia, polyuria and nephrogenic diabetes…
Pediatrics

Congenital anomalies/polycystic kidney disease

Overview: What every practitioner needs to know Are you sure your patient has congenital anomalies/polycystic kidney disease? What are the typical findings for this disease? Congenital anomalies of the kidney and urinary tract (CAKUT) occur in 1 in 500 births, account for the most cases of pediatric end-stage kidney disease (ESKD), and predispose an individual…
Nephrology Hypertension

Acute Kidney Injury: Cardiorenal Syndromes (acute decompensated heart failure and worsening renal function)

Does this patient have acute decompensated heart failure and worsening renal function? The co-existence of cardiac and renal impairment has been called “Cardiorenal Syndrome (CRS).” Initial attempts at defining CRS described it as a state in which therapy to relieve heart failure symptoms was limited by worsening renal function. However, the bidirectional interplay between these…
Critical Care Medicine

Life threatening toxicities of chemotherapies and immunomodulating medications

1. Description of the problem What every clinician needs to know Life threatening toxicities of chemotherapies and immunosuppressants can occur with varying frequency depending on the agent suspected and underlying patient risk factors. It is important for clinicians to remember that these medications can be the cause or contributor to many important complications that occur…
Infectious Diseases

Streptococcus agalactiae (Group B)

OVERVIEW: What every clinician needs to know Pathogen name and classification Streptococcus agalactiae or group B streptococcus (GBS)—a gram-positive, β-hemolytic organism in the Streptococcus genus that carries the Lancefield group B antigen. GBS are encapsulated organisms and ten antigenically distinct capsular serotypes have been described (1a, 1b, II–IX). What is the best treatment? What are…
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